Pakistan scales DHIS2 to more than 1,650 health facilities, improving care for mothers and children
Health authorities in Balochistan province replaced paper-based reporting with DHIS2, raising reporting compliance from 55% to 90% as births in health facilities rose from 35% to 62%.
For years, health officials in Balochistan faced a familiar problem: by the time data arrived from health facilities across Pakistan’s largest province, it was already outdated. A recent Unicef article on this implementation describes the situation vividly. Health workers recorded patient information manually throughout the month, and at the end of each reporting period, district teams compiled and entered the figures—a slow process that made it nearly impossible to respond quickly to emerging health needs.
“The process was slow and placed a heavy burden on district health teams,” said Syed Muzaffar Ali, a senior software engineer at the Directorate General Health Services in Quetta. “More importantly, it delayed our ability to respond to what was actually happening in communities.”
To address these challenges, Balochistan’s health authorities extended DHIS2 to every district in the province, connecting more than 1,650 primary and secondary health facilities and training 4,500 health workers to report daily rather than monthly. With technical support from HISP Pakistan, officials can now see maternal, newborn and child health data as it is recorded, and have used it to identify and correct service gaps at individual facilities.
Those data are now showing results. Reporting compliance rose from 55% in May 2025 to 90% in July 2026, after provincial leaders began reviewing DHIS2 dashboards directly with district managers. Over roughly the same period, more primary health care facilities stocked essential medicines and had properly equipped labor rooms, and the share of births taking place in health facilities rose from 35% to 62%.
A province-wide rollout built on health worker training, offline data capture and local adaptation
Balochistan’s health authorities began deploying DHIS2 in December 2023, and by 2025 the system covered all districts in the province, connecting more than 1,650 primary and secondary health facilities to a single digital platform. To support the transition, 4,500 health workers at district and provincial levels were trained across the province, enabling a shift from monthly to daily data entry.
Where internet connectivity is unavailable, a common challenge across Balochistan’s vast and mountainous terrain, the DHIS2 mobile app allows offline data capture, with automatic syncing once a connection is restored. HISP Pakistan worked with local health workers to adapt the platform to rural and underserved districts.
The province now runs nine core DHIS2 modules, ranging from daily and monthly facility reporting to medicines, birth and death notification, nutrition and lady health worker programs. Another 13 platforms support the work, including a digital human resources system that shows managers which staff are present alongside the services being reported.
“The rollout of DHIS2 across Balochistan represents a significant step forward in digital health governance. Thanks to strong government leadership and close collaboration with partners, the province now benefits from real-time visibility of health service delivery. This enables faster decision-making, strengthens accountability, and ultimately delivers better health outcomes for children and families.” – Dr. Amir Akram, Unicef health specialist.
Faster detection of service gaps, supply shortages and potential outbreaks across all districts
The impact of real-time data became clear quickly. Dr. Ababgar Baloch, provincial coordinator for the Balochistan Health Management Information System, described one example at the 2026 DHIS2 Asia-Pacific Conference in Sri Lanka. When no births were recorded at a remote rural health facility over a period of two weeks, the gap was flagged for investigation. Officials discovered the facility’s labor room was out of service due to faulty equipment, and corrective action was taken immediately. Under the previous system, the problem might have gone undetected for much longer.
Using a provincial health dashboard developed with HISP Pakistan, health authorities can now monitor trends across all districts simultaneously, directing medicines and resources where they are needed and detecting potential outbreaks earlier.
“Ultimately, digital transformation is about more than technology; it is about using better information to improve the health and well-being of communities, said HISP Pakistan CEO Adnan Bashir. “The province-wide DHIS2 deployment provides Balochistan with a foundation for more timely, transparent, and evidence-informed decision-making. We are proud to be part of this milestone and remain committed to supporting the province as it continues to strengthen its health system through digital innovation.”
Better-equipped facilities and more births in health facilities
The damaged labor room equipment in that remote facility was not an isolated case. According to provincial survey and monitoring data, the share of primary health care facilities with essential medicines rose from 46% to 89%, and the share of labor rooms meeting minimum equipment standards rose from 11% to 94% since 2025. Over the same period, births in health facilities increased from 35% to 62%, and full immunization coverage among children rose from 38% to 57%.
Baloch explained the link between these figures in terms of trust. A woman who arrives at a facility to give birth and finds no equipment, no medicine and no trained midwife may not come back. When facility data are monitored closely, those gaps become visible to provincial leaders, and as facilities are equipped and staffed, more women choose to give birth there.
While these gains also coincide with broader health-sector reforms in the province, the DHIS2-based system has given officials something they’ve never had before: timely, facility-level evidence about where to act.
Leadership accountability, backed by government investment
As Baloch described in his presentation at the Asia-Pacific Conference, reporting compliance in DHIS2 stood at 55% when the first provincial health leadership conference was held in May 2025. The managers responsible for each of the 22 DHIS2 modules and supporting platforms were asked to present their compliance and data quality figures, one module at a time, directly to the Minister of Health, the Secretary of Health and the Director General of Health. Districts and facilities that performed well were recognized in front of their peers, and where reporting fell short, leadership acted. The reviews were repeated every few months, and by July 2026, compliance had reached 90%.
“Routine reporting improves when accountability is visible,” said Baloch.
To check that the reported numbers hold up, an independent monitoring unit under the Secretary of Health has recruited 84 monitors, which comes to two to four for each district. They visit facilities and compare the data in DHIS2 against facility records.
The data presented in these reviews also helped make the case for public funding. Health information system staff, supported by the HISP Centre at the University of Oslo (HISP UiO), HISP Pakistan and Unicef Pakistan, used DHIS2 results to show provincial leaders where reporting was improving and where it was falling short. The provincial government has since committed 1.5 billion Pakistani rupees (about $5.3 million) and assigned 80 technical staff, including software engineers, developers, surveillance officers and data analysts, to a dedicated provincial unit.
For Baloch, government ownership is what makes the system last. Partner support is valuable, he said, but “partners come for a limited time with limited resources.” When the ministry is involved and the budget is in place, the modules become sustainable.
A long-term partnership and a focus on data quality
In September 2026, the Balochistan Health Department signed a memorandum of understanding (MoU) with HISP UiO for long-term collaboration on DHIS2, in an agreement covering primary health care digitalization, climate and health, and artificial intelligence. The memorandum also commits the Health Department to building its own national DHIS2 core team.
“It’s quite an inspiration to see how leadership can create enthusiasm, but also investment in the digitalization of the health information systems. We at the University of Oslo and the HISP Centre, through the MoU, are committed to support the government of Balochistan to build a strong implementation, where we can create hopefully better data for decisions, for the benefit of the health service provided at the country level. – Prof. Kristin Braa, HISP UiO director
The next step is measuring data quality more fully. Building on its compliance gains, the Health Department plans to track the completeness, timeliness, consistency and accuracy of reported data against sampled source records.
